[920] Renal Tumors in End Stage Renal Disease.

Jason D Pimentel, Oleksandr N Kryvenko, Nilesh S Gupta, Bruce A Jones. Henry Ford Hospital, Detroit, MI

Background: Historically the majority of renal tumors reported in end-stage renal disease were papillary renal cell carcinoma (PRCC) but, it has been recently proposed that acquired cystic disease-associated RCC (ACDRCC) and clear cell papillary RCC (CCPRCC) are more common in ESRD. Therefore, we decided to characterize renal tumors from patients with ESRD at our institution.
Design: We performed a text-based search for ESRD and renal tumors in our pathology information system. After cases were retrieved, clinical data was reviewed and hematoxylin and eosin stained slides were characterized morphologically by a genitourinary pathologist. Immunostains for CK7, CD10, EMA and AMACR were performed on representative blocks.
Results: We evaluated 23 tumors from 20 ESRD patients, retrieved from 2005 to early 2010. 17 patients had radical nephrectomy for tumor. 3 patients had tumors diagnosed at autopsy. By morphology and immunohistochemistry 8/23 (34.8%) of tumors were CCPRCC, 7/23 (30.4%) PRCC, 3/23 (13%) clear cell RCC (CCRCC), 3/23 (13%) ACDRCC and 2/23 (8.7%) chromophobe RCC (CH-RCC). In the subset of tumors from patients with acquired cystic disease, 6/16 (37.5%) were CCPRCC, 3/16 (18.8%) CCRCC, 3/16 (18.8%) PRCC, 3/16 (18.8%) ACDRCC and 1/16 (6.3%) CH-RCC. The majority of the tumors were pT1a (18/23), three were pT1b and two were pT2. 18/20 (90%) patients were African-American. The male-to-female ratio was 3:1.

Immunostain Reactivity
 CK7 +, f, negCD10 +, f, negEMA +, f, negAMACR +, f, neg
CCRCC0/3, 0/3, 3/33/3, 0/3, 0/32/3, 1/3, 0/33/3, 0/3, 0/3
PRCC6/7, 1/7, 0/75/7, 1/7, 1/75/7, 1/7, 1/77/7, 0/7, 0/7
CCPRCC8/8, 0/8, 0/81/8, 2/8, 5/88/8, 0/8, 0/80/8, 0/8, 8/8
ACD1/3, 0/3, 2/33/3, 0/3, 0/31/3, 2/3, 0/33/3, 0/3, 0/3
CH-RCC2/2, 0/2, 0/20/2, 2/2, 0/22/2, 0/2, 0/20/2, 2/2, 0/2
+, positive; f, focal; neg, negative



Immuno-morphologic features
 CK7CD10EMAAMACRPapillary feat.Other feat.
PRCC+++++ 
PRCC+++++ 
PRCC+++++ 
PRCC+++++ 
PRCC+f+++ 
PRCC++-++ 
PRCCf-f++ 
CCPRCC+-+-+ 
CCPRCC+-+-+ 
CCPRCC+-+-f 
CCPRCC+-+-f 
CCPRCC+f+-+ 
CCPRCC+f+-+ 
CCPRCC+++-+ 
CCPRCC+-+-f 
CCRCC-+++-HG
CCRCC-+f+- 
CCRCC-+++-HG
ACDRCC++++-C
ACDRCC-+f+-C
ACDRCC-+f+-C
CH-RCC+f+f- 
CH- RCC+f+f- 
f-focal, HG-hyaline globules, C-Oxalate crystals


Conclusions: In our cohort of ESRD patients, CCPRCC was the most frequent renal tumor. CCPRCC was also the most frequent tumor in the patients with acquired cystic disease.
Category: Genitourinary (including renal tumors)

Monday, February 28, 2011 9:30 AM

Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 109, Monday Morning

 

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